Psychiatrist describes early dealings with, giving drugs to Riley family

Monday

Jan 25, 2010 at 12:01 AMJan 25, 2010 at 12:28 PM

Dr. Kayoko Kifuji testified Monday under immunity in Carolyn Riley's murder trial about her extended history with the family of Rebecca Riley, the 4-year-old Hull girl who died of what authorities say was excess use of prescription drugs.

John P. Kelly

Dr. Kayoko Kifuji testified Monday under immunity about her extended history with the family of Rebecca Riley, the 4-year-old Hull girl who died of what authorities say was excess use of prescription drugs. Her parents claim that the girl died of pneumonia.

Her testimony in Plymouth County Superior Court in Brockton came on the sixth full day of the murder trial of Carolyn Riley, Rebecca's mother who authorities accuse of working with her husband, Michael, to kill the young girl by giving her too many drugs.

After a 10-minute meeting involving Judge Charles J. Hely and lawyers for the prosecution, defense and Kifuji, the Boston psychiatrist took the stand. Her lawyer, Bruce Singal, would not comment on what brought about the call for immunity. It has been determined that Kifuji will not face criminal charges in the case, though a civil lawsuit is pending against her.

Early testimony Monday focused on the first dealings in April 2003 between Carolyn Riley and Kifuji, then a psychiatrist at Bay State Medical Center in Springfield. Kifuji testified that she diagnosed Rebecca's older sister with bipolar disorder and attention deficit hyperactivity disorder after a brief meeting with Carolyn. She did so based solely off reports that Carolyn had given about her daughter, including what the mother described as depression, sleep disorder and an attack on her older brother. Kifuji also said she took a family history, in which Carolyn Riley told her that her husband, her own mother and her older son had been diagnosed as bipolar.

Kifuji testified that she transferred the Rileys' case to another doctor after she moved onto what was then Tufts New England Medical Center. (The facility is now known as Tufts Medical Center.) But Kifuji said that, months later, she got a call from Carolyn Riley expressing concern that she couldn't find another doctor to prescribe medication for Rebecca's sister. Based on this conversation, Kifuji called in a prescription to a pharmacy over the phone.

In the subsequent months, according to testimony, Kifuji was giving the older sister more pills of Depakote -- used to treat bipolar disorder -- than was recommended under dosage guidelines. Also, during that period, she began prescribing the powerful blood pressure medication Clonodine to Rebecca's sister, after Carolyn said the drug had been effective after she gave some already prescribed to her son to the older daughter.

Prosecutors contend the girl's mother, Carolyn Riley, and her father purposefully overdosed Rebecca with Clonidine. The defense contends the Rileys were just following doctor's orders and that the little girl actually died from a fast-moving type of pneumonia.

On Friday, jurors heard from one of the Rileys' neighbors. Sandra Trembley struck up a casual friendship with Carolyn Riley, whose daughter, Rebecca, went to preschool with her son. That the Riley children lived in a home that reeked of urine and smoke bothered her, but Trembley also saw the family in moments of genuine happiness.

In the fourth day of testimony in Carolyn Riley’s murder trial, Trembley said she learned of 4-year-old Rebecca’s death in the newspaper. And she testified on Friday that her experience attending the girl’s wake shook her motherly sensibilities.

“People were coming in crying, and she had no tears,” Trembley said of Carolyn Riley. Even at the end of the service, when state social workers walked into the funeral home to take custody of her two other children, Trembley said Riley remained emotionless.

But what left an even more puzzling impression, Trembley said, was Riley’s response when Trembley expressed her sorrow in a quiet side room there.

“Carolyn Riley told me that Rebecca was sick just like any other child who gets a cold,” Trembley said. Michael Riley had driven her to the pharmacy for cold medicine that night, but the couple found Rebecca “cold and stiff” the next morning, Trembley recalled being told.

But the next witness on the stand, Kelly Williams, who shared a home in Hull with the Rileys in the weeks leading up to Rebecca’s death, described an illness that was anything but a typical cold.

Over nearly four hours of testimony, Williams recounted for jurors in Brockton Superior Court how she watched the little girl’s health deteriorate rapidly over four days – from the sniffles to a feverish delirium. And Williams said Carolyn and Michael Riley ignored her pleas to take Rebecca to a doctor or to the emergency room.

Like her two older siblings, Rebecca had been diagnosed with bipolar disorder and attention deficit hyperactivity disorder.

Toxicology tests following her death on Dec. 13, 2006, led a state medical examiner to determine Rebecca died from a combination of Clonidine, a blood pressure medication; Depakote, a mood-stabilizer; and two over-the-counter drugs, a cough suppressant and an antihistamine.

The night before Rebecca died at the foot of her parent’s bed, Williams said, the girl had clammy skin, a dazed expression and had vomited throughout the day. Repeatedly, the girl wandered the hallway to her parents’ bedroom and knocked at the door.

“She couldn’t even get the whole word ‘mama’ out without choking,” Williams said, tears filling her eyes as she testified.

But Michael Riley turned her away each time, Williams said, giving Rebecca a shove on her third attempt and telling her to “go to her own (expletive) room.”

For days, Williams said she had told Carolyn Riley to take Rebecca to a doctor. Now, her boyfriend, Jimmy McGonnell, who also lived in the home, became so enraged that he kicked open the Rileys’ bedroom door and demanded they take Rebecca to the hospital, Williams said.

It was only afterward that the girl was allowed into the room to sleep. Jurors were shown photographs of where Rebecca was found the next morning, laying lifeless on a carpet stained with vomit.

Twice that week, Williams said the Rileys had taken Rebecca to a Social Security office building to discuss their benefits payments instead of to a doctor.

Another exhibit was a book-sized plastic container Carolyn Riley used to keep track of a multitude of pills for her three children.

Williams said she and her son moved in with Carolyn Riley that October when the family lived in a cramped $50-a-month subsidized apartment in Weymouth. Riley, who collected federal disability benefits for herself and children, once agreed the level of medication seemed excessive.

“She said she was just doing what the doctor said,” Williams testified.

Williams said Carolyn became withdrawn when Michael Riley moved into their new home in Hull in late November or early December. He frequently screamed and swore at the children, according to Williams, who said she saw him slap his son in the head and throw Rebecca to the ground.

“Go get the medication. We need to calm these kids down,” Michael often said, according to Williams, referring to the Clonidine.

Williams said Carolyn Riley began giving the children their “sleeping pill” as early as 5:30 p.m., instead of 7:30 p.m., as she had done routinely when they lived in Weymouth.

The morning Rebecca died, while police and emergency responders were still in the home, Williams described Michael Riley as “irritated” as he paced the room with his cell phone, trying to get in touch with “the psychiatrist.”

Williams said Riley could not find the medication for his other children and wanted a refill prescription because they were “acting up.”

Frank Middleton, a Plymouth prosecutor, asked Williams what the children were doing.

Williams said Rebecca's sister and brother were “sitting in a circle” and “playing with toys.”

John P. Kelly may be reached at jkelly@ledger.com.

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